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Tyrone on single-payer health insurance
I'm still receiving emails requesting this topic. Tyrone says it is so simple it is barely worth the bother, but I traded favors so he would handle it...
"Any dummkopf can see we should value human life at replacement cost, not willingness to pay in a market setting. (If P > MC, due to monopoly, MC is the correct measure of value, especially if we can produce more of the stuff.) And what is the replacement cost required to get another baby into the world? A pittance. We should spend half as much on health care as we are doing now, perhaps less.
Let's institute rationing, and yes nationalization of either insurance or service provision are possible means to that end. Let's give everyone access to basic preventive care but limit or perhaps even ban all expensive life-prolonging procedures. At the same time, our other policies should be pro-natalist, and that includes a favorable environment for religion and restricted vacation time, not just dollar bonuses for kids and free public education. No good utilitarian can resist that conclusion.
Yes, that treats human lives as interchangeable, but if you don't buy that, you have no business defending the economic approach to human life in the first place. (The Devil in Goethe's Faust: "Warum machst Du gemeinschaft mit uns, wenn Du sie nicht durchfuehren kannst?")
By the way, let's drive down pharmaceutical prices. Subsidizing babies is a cheaper way of producing more years of life.
Yup, it's all about churning out those Quality-Adjusted Life Years. Current unborns may feel hypothetical or contingent to you, but I tell you, they are just as real as I am. And when those people come into existence -- if they come into existence -- they will be more real than I am.
At best, even assuming away the usual market failure issues, market-driven health care allows people to invest too many real resources keeping themselves alive. You can kick and scream all you want, but at the end of the day you cannot escape this obvious overinvestment. The problem is that the market works, in the sense of getting people what they want. And if government involvement can save on insurance company overhead at the same time, or alleviate adverse selection, so much the better."
Tyrone is so depressed, and so unhappy with who he is, that he comes up with drivel like this. Why did I even pass on the request? After jotting down these notes, Tyrone told me that if push ever came to shove, I should not spend more than $8000 keeping him alive. Of course I refused to agree; what would I do without him? What would my wife do without him? And what kind of person would you think I am, to sell him for mere dollars and cents?
Addendum: Here is Will Wilkinson's health care plan.
Posted by Tyler Cowen on March 21, 2006 at 07:05 AM in Medicine | Permalink
Comments
I’m not sure quite how he’d sell that argument to NOW. It’s an explicity anti-abortion one.
Posted by: Tim Worstall at Mar 21, 2006 7:32:57 AM
I see Tyrone has embraced Parfit's Repugnant Conclusion.
Posted by: Brock at Mar 21, 2006 7:58:21 AM
Who said Tyrone was brilliant? One demagoguery after another, manipulative half-truths or even clearly untrue statements. No logic, no substance.
Posted by: PK at Mar 21, 2006 9:34:34 AM
But Tyrone does not take his logic far enough. A baby is not a "replacement" for a prime-aged educated contributor to society. The "opportunity cost" of a person is his yet unproduced contributions to society and is roughly proportional to his unrealized permanant income. (Likely not equal because not all contributions are marketed, e.g., companionship, frindship, wit, blog contributions.) Therefore, the replacement costs will differ greatly depending on the individual being replaced. State assesment of the relative values of individuals has caused all sorts of unpleasantness. Strict adherance to voluntary exchange does not.
To the extant that markets do work, across individuals, one's wealth available to purchase health care is roughly proportional to this opportunity cost. To a first approximation, investment in health care is likely close to opportunity cost. Admittedly, as individuals age, their available permanant income is likely higher than this opportunity cost, causing some over-investment in life-prolonging health care. Indeed, I suspect Tyrone is "worth" considerably more than $8,000, at least until he becomes much more infeebled.
Posted by: MW at Mar 21, 2006 9:56:36 AM
The replacement cost issue is simple, anyone who wants life-saving medical care should be forced to issue stock in their future earnings, which will provide a useful valuation.
Posted by: Mr. Anti-Econotarian at Mar 21, 2006 10:20:17 AM
I don't agree that this is an anti-abortion argument. The replacement cost of a feus is extemely low (actually, the replacement cost for a fetus is probably substantially negative for most people).
Posted by: FXKLM at Mar 21, 2006 10:25:10 AM
MW is correct- the replacement value of a human being is not twhat it costs to create a baby, but what it costs to create an *equivalent human being*- same age, knowledge, skills, etc
When you look at it that way, the costs shift considerably- even if you figure you can replace with a younger adult and train, you're still incurring the cost of creating a 22yo (and training the new guy).
Humans are sentient capital and should be priced as such, at the very least...
Posted by: Brian Doss at Mar 21, 2006 10:59:24 AM
Actually replacement cost includes at the minimum time to grow to usefulness and all needed training. For an illustration see McNeill's Plagues and Peoples; "Thus by a paradox that is only apparent, the more diseased a
community, the less destructive its epidemics become." p.197; because most die in childhood before resources are spent on their maturation and training.
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